News From Around the Web
> Three fraud and abuse laws will undergo revisions in the first half of 2016, including one that will increase civil monetary penalties (CMPs). An agency rule list released by the White House Office of Management and Budget indicates that the government will roll out a final rule in May 2016 that revamps the way the Office of Inspector General can impose CMPs and provider exclusions. Rule list
> A District of Columbia dermatologist was acquitted on charges of being engaged in an insurance fraud scheme involving unnecessary skin-removal procedures, according to the Washington Post. Prosecutors portrayed Amir Bajoghli as a greedy practitioner that performed unnecessary cancer-removal procedures and improperly billed insurance companies for skin cell slides, suturing and skin grafts. However, defense attorneys argued that every procedure Bajoghli did was medically necessary, leading the jury to clear him of all 41 charges. Article
> A Texas skilled nursing facility agreed to pay $3.2 million to settle allegations that it took kickbacks from ambulance companies in exchange for Medicare and Medicaid transport referrals. Regent Management Services LP, which managed 12 facilities in seven different cities, settled claims that patients received free or discounted ambulance transportation while providing other lucrative referrals to those same ambulance companies. Announcement
Health Payer News
> UnitedHealth Group's CEO has offered more details on why the insurer is considering pulling out of the Affordable Care Act exchanges in 2017. Stephen J. Hemsley told investors that the company should have waited longer to join the market rather than joining in the second year. Hemsley also said he's not sure whether UnitedHealth's losses are linked to the company or the marketplace. Article
Health IT News
> The year isn't quite over yet, but IBM is anointing 2015 the year of the healthcare security breach. In a new report, the company notes that five of the eight largest healthcare cybersecurity breaches occurred in the first half of the year, leading to nearly 100 million compromised healthcare records. Healthcare leads all industries in security breaches in the first 10 months of the year, compromising 34 percent of health records. Article
And finally… What's this building screaming about anyway? Article